Provider Demographics
NPI:1699707729
Name:SWANSEN, SARA A (PH D)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:A
Last Name:SWANSEN
Suffix:
Gender:F
Credentials:PH D
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Other - Credentials:
Mailing Address - Street 1:2929 WESTOWN PARKWAY
Mailing Address - Street 2:SUITE 110 DES MIONES PASTORAL COUNSELING CENTER
Mailing Address - City:WEST DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50266
Mailing Address - Country:US
Mailing Address - Phone:515-274-4006
Mailing Address - Fax:515-255-5697
Practice Address - Street 1:2929 WESTOWN PARKWAY
Practice Address - Street 2:SUITE 110 DES MIONES PASTORAL COUNSELING CENTER
Practice Address - City:WEST DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50266
Practice Address - Country:US
Practice Address - Phone:515-274-4006
Practice Address - Fax:515-255-5697
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IA00884103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist